The Skeptics' Guide to EM

AUGUST 14, 2021

Survival After Intravenous Versus Intraosseous Amiodarone, Lidocaine, or Placebo in Out-of-Hospital Shock-Refractory Cardiac Arrest. Survival After Intravenous Versus Intraosseous Amiodarone, Lidocaine, or Placebo in Out-of-Hospital Shock-Refractory Cardiac Arrest. Date: August 12th, 2021 Reference: Daya et al.

Shock 52

Shock CPR Hyperthermia / Hypothermia EMS 52

PHEM Cast

APRIL 16, 2018

The outcomes from different resuscitative interventions in a haemorrhagic shock model in porcine model: From: Watts et al. Use of CPR in hemorrhagic shock, a dog model. Survival and neurological outcome after OOH TCA in pediatric & adult populations: a systematic review. Ultrasound during TCA: Cureton et al.

Resuscitation 52

Resuscitation Shock Ultrasounds CPR 52

AED Leader

APRIL 24, 2024

Their AEDs are designed to be user-friendly, reliable, and effective in delivering life-saving shocks to restore a normal heart rhythm. It has advanced features that simplify the rescue process and improve outcomes. Let’s delve into the key features and benefits of Cardiac Science AEDs.

CPR 52

CPR Shock Pediatrics Documentation/Coding 52

The Skeptics' Guide to EM

DECEMBER 7, 2018

You are the first provider on scene with Emergency Medical Services (EMS) and start high-quality Cardiopulmonary Resuscitation (CPR). He is unsuccessfully shocked. There was also no increase in survivors with good neurological outcomes with ACLS. JAMA 2009, Hagihara et al. Reference: Perkins et al.

Advances Cardiac Life Support (ACLS) 52

Advances Cardiac Life Support (ACLS) CPR Resuscitation Hospitals 52

AED Leader

DECEMBER 2, 2024

Furthermore, regular maintenance and training in cardiopulmonary resuscitation (CPR) techniques significantly enhance the potential effectiveness of AEDs in emergencies. Defibrillation: Once a dangerous rhythm is detected, the AED delivers a controlled electric shock to help restore normal heart rhythm.

CPR 52

CPR Basic Life Support Resuscitation Hospitals 52

The Skeptics' Guide to EM

FEBRUARY 25, 2023

He is found to be in hypoxic respiratory failure and septic shock. Your team begins high quality cardiopulmonary resuscitation (CPR). Apart from high-quality CPR and early defibrillation, many other interventions we try lack a strong evidence base. Parents note that he has been progressively more tired and difficult to arouse.

Pediatrics 52

Pediatrics Hospitals CPR Resuscitation 52

RebelEM

DECEMBER 19, 2022

This procedure involves applying another set of pads attached to a second defibrillator to a patient and shocking them in hopes of terminating the rhythm. Background Information: Double external defibrillation (DED) is an intervention often used to treat refractory ventricular fibrillation (RVF).

EMS 52

EMS CPR Shock Resuscitation 52

The Skeptics' Guide to EM

JANUARY 9, 2021

CPR is currently in progress with a single shock having been delivered. This has included things like therapeutic hypothermia ( SGEM#54 , SGEM#82 , SGEM#183 and SGEM#275 ), supraglottic devices ( SGEM#247 ), crowd sourcing CPR ( SGEM#143 and SGEM#306 ), and epinephrine ( SGEM#238 ).

EMS 52

EMS Resuscitation CPR Hyperthermia / Hypothermia 52

The Skeptics' Guide to EM

FEBRUARY 3, 2023

The nurses started CPR immediately and place pads before you even arrived. The patient is in ventricular fibrillation, and you achieve return of spontaneous circulation (ROSC) on the second shock. The patient is still unconscious. A post-arrest ECG doesn’t show any signs of STEMI. This translated into an impressive NNT of 6.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Hospitals Documentation/Coding CPR 52

The Skeptics' Guide to EM

SEPTEMBER 11, 2021

The paramedics achieve return of spontaneous circulation (ROSC) after CPR, advanced cardiac life support (ALCS), and Intubation. She arrives in the emergency department (ED) with decreased level of consciousness and shock. She has a history of hypertension and non-insulin dependent diabetes mellitus.

EKG/ECG 52

EKG/ECG Academics EMS CPR 52

EMDocs

JANUARY 11, 2024

Data that do not establish neurological risk stratification in the first 6 hours after CA include the patient’s age, duration of CPR, seizure activity, serum lactate level or pH, Glasgow motor subscore in patients who received NMB or sedation, pupillary function in patients who received atropine, and optic nerve sheath diameter (95.3%, 20/21).

Seizures 91

Seizures Shock Infectious Diseases CPR 91

AED Leader

JULY 1, 2024

It features ADAPTIV biphasic waveform technology, which adjusts energy levels based on the patient’s needs, ensuring effective and safe defibrillation shocks. With quick charging and short analysis times, the LifePak 100 allows for rapid intervention, increasing the chances of a positive outcome.

Pediatrics 52

Pediatrics CPR Operations Resuscitation 52

Don't Forget the Bubbles

JUNE 26, 2023

But, they may present postnatally with cyanosis/hypoxaemia due to insufficient pulmonary blood flow, cardiogenic shock due to insufficient systemic blood flow, or both. The team start CPR, and this is emergently converted to extra-corporeal cardiopulmonary resuscitation via the open sternotomy wound. What is the best option for repair?

Operations 127

Operations Research Hyperthermia / Hypothermia Hospitals 127

ACEP Now

NOVEMBER 7, 2023

1 Overall, survival is poor following cardiac arrest, and is affected by factors including age, comorbidities, witnessed arrest, early CPR, early defibrillation, and return of spontaneous circulation (ROSC). The primary outcome was survival to hospital discharge. 2020;396(10265):1807-1816. Alaeddini J, Feng Z, Feghali G, et al.

Resuscitation 52

Resuscitation Hospitals Shock CPR 52

Dr. Smith's ECG Blog

NOVEMBER 23, 2022

He underwent CPR and then was shocked out of VF. He was in cardiogenic shock requiring an impella for several days after cath. Sooner identification likely leads to better outcomes, and in this case may have allowed prevention of cardiac arrest and better long-term outcome. No further troponins were measured.

EKG/ECG 52

EKG/ECG Shock CPR Outcomes 52

ACEP Now

APRIL 3, 2024

1,2 However, the European TTM1 trial in 2013 showed similar outcomes for those cooled to 33 degrees Celsius compared to 36 degrees Celsius, leading to a 2015 AHA class I recommendation of “cooling between 32 degrees Celsius-36 degrees Celsius.” degrees Celsius. 5,6 In 2021, the TTM2 trial was published. degrees Celsius for 72 hours.

Hyperthermia / Hypothermia 40

Hyperthermia / Hypothermia Resuscitation Outcomes Hospitals 40

Advanced Emergency Nursing from AENJ

NOVEMBER 24, 2016

If doing what was called "the one-man-band resurrection shuffle" [single person CPR in the back of a moving ambulance], this worked very well, as the bag would stay hanging there on the patient's face. These indices would have reinforced the clinical decision progress and avoided bad outcomes from unsuccessful estimates.

Emergency Nursing 40

Emergency Nursing CPR Seizures Wellness 40

RebelEM

SEPTEMBER 14, 2023

Background: Cardiogenic shock develops in up to 10% of patients with acute myocardial infarction (AMI) and carries a 30 day mortality rate around 50%. Extracorporeal Life Support in Infarct-Related Cardiogenic Shock. to 1.03) Poor Neurologic Outcome (CPC 3 or 4): 24.8% to 1.03) Poor Neurologic Outcome (CPC 3 or 4): 24.8%

Shock 136

Shock Outcomes Resuscitation Stroke 136

PulmCCM

JUNE 19, 2025

Pre-hospital, she received ACLS-guided resuscitation with regular epinephrine injections and at least 5 shocks, first by the on-site AED and then by EMS, delivering 200 joules by a biphasic defibrillator. Approximately 20 minutes have elapsed since the initiation of CPR. Physicians receive no formal guidance on how long to perform CPR.

CPR 59

CPR Shock Resuscitation Outcomes 59

Taming the SRU

JUNE 28, 2024

4) This higher likelihood of attaining return of spontaneous circulation (ROSC) is contingent upon high quality CPR and early defibrillation. One therapy is vector change defibrillation, in which the defibrillation pads are placed in the anterior posterior configuration to change the direction of the shock delivered through the myocardium.

Shock 96

Shock Hospitals CPR Outcomes 96

Don't Forget the Bubbles

FEBRUARY 5, 2025

There is significant evidence in adults and developing in the paediatric population that TXA results in better outcomes if given early in patients with mild to moderate traumatic brain injury (TBI) and does not cause harm. Immediate Treatment One immediate medication to consider is tranexamic acid (TXA).

Domestic Violence 57

Domestic Violence Fluid Resuscitation Head Injuries Sexual Assault 57

Dr. Smith's ECG Blog

NOVEMBER 12, 2020

He underwent CPR, and regained a pulse after epinephrine, with an organized narrow complex rhythm at 140, but still with severe shock. Assessment was severe sudden cardiogenic shock. He remained hypotensive and in shock. Cardiovascular Implications of Fatal Outcomes of Patients With Coronavirus Disease 2019 (COVID-19).

Shock 52

Shock EKG/ECG Outcomes Hospitals 52

PulmCCM

JANUARY 29, 2024

Epinephrine remains the drug of choice during CPR Epinephrine remains the first-line therapy for cardiac arrest due to non-shockable rhythms (i.e., No new evidence arose to alter the usual schedule of administering 1 mg epinephrine as quickly as possible, then every 3 to 5 minutes while CPR is ongoing. PEA and asystole).

CPR 115

CPR Seizures Documentation/Coding Hyperthermia / Hypothermia 115

Emergency Medicine Journal

OCTOBER 26, 2023

Inclusion criteria were non-traumatic cardiac arrests treated with at least one external electric shock with an automated external defibrillator from the basic life support team and resuscitated by a physician-staffed ALS team. Primary outcome was survival at hospital discharge with a good neurological outcome.

Resuscitation 75

Resuscitation Basic Life Support Hospitals CPR 75

RebelEM

SEPTEMBER 28, 2023

The STREAM-1 trial found that for [2] patients with STEMI presenting within 3 hours of symptom onset and unable to attain PCI within 1 hour of first medical contact, a pharmaco-invasive strategy resulted in similar rates of death, shock, heart failure, or reinfarction compared to primary PCI. Primary PCI: 95.7% Primary PCI: 95.7%

EKG/ECG 137

EKG/ECG Allergic Reactions Shock Stroke 137

Dr. Smith's ECG Blog

JUNE 23, 2024

His daughter immediately started CPR and another family member called EMS. They shocked him twice before return of spontaneous circulation. Written by Willy Frick A man in his 50s was at home with his family when they heard a thud and rushed into the room to find him unconscious with agonal respirations.

EKG/ECG 121

EKG/ECG CPR EMS Hospitals 121

AED Leader

SEPTEMBER 21, 2024

Why is defibrillation important Defibrillation is the process of delivering an electrical shock to a person experiencing life-threatening heart rhythms, like ventricular fibrillation (VF) or pulseless ventricular tachycardia. The defibrillator administers a shock measured in joules to the heart at precisely the right moment.

CPR 52

CPR Shock Resuscitation Hospitals 52

RebelEM

JANUARY 29, 2024

in the paper but 2.7% to ≈0.99 (p<0.001) Mean MPI/Tei Index≈ 0.47 in the paper but 2.7% to ≈0.99 (p<0.001) Mean MPI/Tei Index≈ 0.47 in the paper but 2.7% to ≈0.99 (p<0.001) Mean MPI/Tei Index≈ 0.47 in the paper but 2.7% to ≈0.99 (p<0.001) Mean MPI/Tei Index≈ 0.47 to 4.0mg/hr typically given in EKOS therapy (See Below).

Stroke 136

Stroke Outcomes Hospitals Administration 136

PulmCCM

JUNE 5, 2023

Corticosteroids for community-acquired pneumonia have been studied with inconclusive results, and expert guidelines currently advise against their use except in patients with refractory septic shock. Patients with septic shock or influenza were excluded. standards of care. makes me long for an adequately powered randomized trial.

Advances Cardiac Life Support (ACLS) 96

Advances Cardiac Life Support (ACLS) Documentation/Coding CPR Shock 96

Stop and Think

JANUARY 10, 2024

One scenario that doctors considered dire enough to use ECLS occurs when CPR does not work to restore circulation. In January, Dutch investigators published results of the INCEPTION trial, in which extracorporeal cardiopulmonary resuscitation (CPR) or conventional CPR (standard advanced cardiac life support) were compared.

CPR 44

CPR Shock Outcomes Resuscitation 44

AED Leader

AUGUST 22, 2024

By delivering an electric shock to restore normal heart rhythm in cases of ventricular fibrillation or other arrhythmias, AEDs play a vital role in increasing survival rates following sudden cardiac arrests. If it detects such a problem, it delivers an electric shock to restore normal heart function. How does an AED Work?

CPR 52

CPR Shock Operations Outcomes 52

AED Leader

SEPTEMBER 27, 2024

The defibrillator sends an electric shock to stop this chaos, letting the heart’s natural pacemaker take back control. Giving a shock in time might just save a life. ” This portable lifesaver guided us with voice prompts as we attached it and administered a shock.

Shock 52

Shock Operations CPR Outcomes 52

Taming the SRU

OCTOBER 1, 2023

As these patients are typically already at a high risk for poor health outcomes, secondary spontaneous PTX is often more serious in presentation and management more complex [11]. J Emerg Trauma Shock. Persistent air-leak in spontaneous pneumothorax--clinical course and outcome. Ann Emerg Med. 1983;12(6):411-412. 2008;1(1):34-41.

Fractures 105

Fractures COPD Hospitals Radiology 105

Don't Forget the Bubbles

OCTOBER 7, 2024

Was the patient thrown from the source (suggestive of DC shock and may result in further blunt force trauma)? Children, especially toddlers, may insert objects into outlets, leading to shocks or burns. Electrical devices used near water sources can cause severe shocks. Was the voltage high or low (as below)?

Burns 78

Burns Fluid Resuscitation Shock Resuscitation 78

EMDocs

JANUARY 16, 2024

Patients can have excellent outcomes despite prolonged resuscitation. 10 The score predicts the probability of survival to hospital discharge using a number of factors including CPR duration, serum potassium, core temperature, age, and suspected mechanism of hypothermia. Hypothermic arrest differs from cardiac arrest from other causes.

Hyperthermia / Hypothermia 95

Hyperthermia / Hypothermia Resuscitation CPR EMS 95

AED Leader

SEPTEMBER 26, 2024

This device can shock the heart back into rhythm. Key takeaways Defibrillators are devices that send electrical shocks to the heart to fix dangerous rhythms. AEDs can save lives outside hospitals by giving quick shocks when someone has a sudden cardiac arrest. It sends an electrical shock to the heart. Hold off the shock!”

Shock 52

Shock CPR Hospitals EMS 52

AED Leader

APRIL 30, 2024

AEDs are designed to deliver a life-saving shock to the heart, restoring its normal rhythm and allowing vital organs to receive the needed oxygen. CPR Coaching and Feedback In addition to delivering a life-saving shock, the Heartsine 350P AED provides real-time CPR coaching and feedback.

CPR 52

CPR Operations Shock Resuscitation 52